1. Comparative analysis of liver resection in Non-B Non-C and hepatitis virus-associated hepatocellular carcinoma.
- Author
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Takamoto T, Nara S, Ban D, Mizui T, Mukai M, Minoru E, and Shimada K
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Operative Time, Survival Rate, Carcinoma, Hepatocellular surgery, Carcinoma, Hepatocellular virology, Carcinoma, Hepatocellular pathology, Liver Neoplasms surgery, Liver Neoplasms virology, Liver Neoplasms pathology, Hepatectomy, Propensity Score
- Abstract
Background: The incidence of non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC) is increasing in our country. This study assesses the feasibility of employing an identical surgical treatment strategy for resectable NBNC-HCC as that for hepatitis virus-associated HCC (HV-HCC)., Methods: A retrospective analysis (1993-2023) of 1321 curative liver resections for HCC at a single institution was performed. Propensity score matching ensured a balanced comparison of preoperative clinical factors, including tumor status and background liver condition., Results: The proportion of NBNC-HCC cases has gradually increased, reaching up to 70 %. After matching, 294 of 473 NBNC-HCC patients and 294 of 848 HV-HCC patients were compared. Operative outcomes, including operation time, blood loss, type of surgical procedure, and morbidity, were comparable. Long-term outcome analysis showed similar recurrence-free survival (HR: 0.86, 95 % CI: 0.70-1.06, P = 0.167) and overall survival (HR: 0.98, 95 % CI: 0.79-1.23, P = 0.865) for NBNC-HCC. Multivariable analysis identified ICGR15 ≥ 15 %, ALBI grade 2 or 3, aspartate aminotransferase ≥40, tumor size > 5 cm, multiple tumors, macrovascular invasion, and microvascular invasion as independent prognostic factors for overall survival, while hepatitis B or C virus status lost significance., Conclusions: Despite the increasing incidence of NBNC-HCC, comparable outcomes were achieved between the two groups of matched cohort., (© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Published
- 2024
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